Diary of A Child Therapist

Sunday, August 7, 2011

One of the most common questions I get from parents who come into my office is how to calm their young child down when he is in the midst of a “meltdown,” a “tantrum” or a “fit.”

Ideally, by a certain age and level of development, a child should be able to mostly maintain calm and not get – or stay - too upset in the first place, but often that just isn’t possible given the situation, a parent’s ability to help soothe a child, and the child’s own capacity for regulating his emotions. (Of course, this ideal also becomes entirely beside the point when a parent is feeling overwhelmed, is in public and feeling the pressure of onlookers, or isn’t at all sure what to do to get his or her child to calm down.)

It is so vital to remember that as parents, we are our children’s first and most important teachers. This is especially true when it comes to learning the crucial skill of managing emotions. While this ability is something we adults often take for granted, for children handling emotions well is a skill that has to be learned and supported to the point of mastery just as we help our children learn how to walk, read, or ride a bike. In other words, managing emotions just isn’t something a child can learn without an adult by his side.

I often use the words “regulation” and “dysregulation” to talk about this. We initially teach infants about regulation by picking them up when they are fussing or crying, using motion such as gentle rocking or words like, “There there, it’s okay,” to help them feel better. When we take such actions, we essentially serve as “training wheels” to help baby learn how to feel soothed, to even know that he can be soothed and calmed.

As babies get older and grow into toddlerhood, we move beyond these very basics toward teaching them about the sophistications of emotional regulation.

I have many parents who come in and tell me that when their children are upset and falling apart, they try to help by encouraging them to “use their words” or “tell me what’s wrong.” I hear the best of intentions in their explanations. Here’s what I tell them, and what I want to remind you of now:

When a young child is having a “meltdown,” he usually isn’t thinking about how much better things would be if only he could use his words. He isn’t thinking in terms of words. All he knows is that he feels just awful inside, that there is a yucky mess inside the middle of his body and he doesn’t know what to do with that feeling. Hence, he screams. Or hits. Or may shout out horribly mean words at his mom and dad.
So what is a parent to do in such a situation?

Maintain CalmFirst things first: maintain calm as much as you can. Like finely calibrated seismic instruments, children pick up on every nuance of our inner quakes and are affected by them. If you are agitated and angry and inadvertently convey this to your child by your actions or words, your child will likely respond in kind.

Mirror: Tell Them What You SeeSecondly, since your child can’t sort out his feelings or needs in the midst of falling apart and verbalize them to you, tell him what you see. This can be conveyed (calmly) in words such as, “I see you’re upset…I see you are very angry right now…I see you are frustrated and sad.” Or, “I know you’re mad. I can see that,” and then you may add, if needed, “But hitting and kicking isn’t okay. We don’t hit and kick even when we feel mad.”

By holding up a mirror (so to speak) in the moment when your child is clearly overwhelmed and confused, you are helping him learn how to put names to his feelings. He may even gratefully think, “Oh! That’s what this yucky stuff inside me is called!”

Be ConsistentThirdly, as always with helping a child to learn any new or emerging skill, consistency is key. If you are able to consistently help your child name and validate his feelings, he will eventually be able to do this more and more on his own. Before you know it, the training wheels will come off and he’ll be flying down the lane to naming all those difficult feelings and using his words rather than acting them out.

The bottom line is that the more you can put into words what your child is feeling or needing for him, the better he will feel – and act. Not only will he learn how to identify emotions, he will also feel that mommy or daddy understands him enough to notice and say what they see is going on. This is a great comfort to any child.

Ah, summer! Ice cold lemonade, refreshing juice, and other icy sweet drinks come to mind. While these tasty beverages can really hit the spot on warm days, they’re also filled with lots of sugar and yes, empty calories.

Shannon Whaley, Director of Research and Evaluation at the Public Health Foundation Women Infants and Children program, recently reported that "Twenty-nine percent of children 0-2 are drinking soda on a typical day. So that's really where we need to start."

There’s a much better way for our little ones to get their thirsts quenched, and that’s by choosing water first. This is especially important for young children who are still developing dietary tastes and habits. It's a simple choice that can profoundly impact their overall health. After all, drink choices can significantly affect dental/oral development and appropriate weight gain.

So help your young child choose – and enjoy – water first instead of sugary drinks. And at mealtimes, include milk for added calcium. These simple actions are some of the most important steps you and family can take toward good health both now and in the future.

And, just in case you were wondering about how many calories or how much sugar is in that drink…

Saturday, July 16, 2011

It’s been a busy time since my family and I relocated to the beautiful Pacific Northwest last May. Which means, as some of you may have noticed, that I’ve taken a break from the blog.

Well, the good news is that after setting up a new home, new private practice, and with a baby on the way, things are actually slowing down enough so that I can now get back to doing things like posting on the blog. Yes, the blog is back!

Speaking of all the busy-ness that’s been going on, and our family’s preparations for further monumental changes in the near future, I’ve been thinking a lot about how parents are able to juggle the day-to-day demands of family life. So many families I know struggle with maintaining order in the home, getting kids to activities all over town, and staying connected and close.

Some important things to remember:
•Be willing to slow down – Now that it’s summer, not rushing off to the next activity. Signing your child up for one less thing.
•Ask for help – If you are overwhelmed or stressed by everything you have to do, is there a family member or friend who can come over and help with the kids or with that gardening or organizational project you’ve been wanting to get done?
•Enjoy low-key (non-stressful) family activities in the local area, such as going to the park; making good food and enjoying regular mealtimes together; and so forth.

This time of year is an ideal time to slow down and do less, so I encourage all you busy parents and families to remember to do just that!

Monday, May 3, 2010

Here's a link to a very useful little article on helping your young child with transitions. Click here!

Speaking of transitions, I've moved my practice up to Bellingham, Washington. For those parents in California and elsewhere, please continue to email me with questions! I am also happy to continue to provide parents in Southern California with referrals for their young children.

Friday, March 19, 2010

[With last week's time change and the lengthening of daylight hours, Spring is the perfect time to think about transitions. This is the first in a series of posts about transitions.]

As I return to writing regular blog posts again after a long period away, I've been thinking a lot about the transitions we make throughout our daily lives, and how we can help our kids with both the small and large ones.

In my own life, transition has definitely been the major word. At the end of April, I'll be leaving Southern California, moving up to northern Washington State with my own little family, and joining a group practice in Bellingham.

There has been a lot to think about and do, including figuring out how on earth to pack up a whole house! As a family, we will have to adjust to many changes including leaving behind people we love, sunny weather, and all that is familiar.

For parents with young children, there are certain things you can do to make a big transition such as a major relocation easier. Parents naturally often worry about how their child will adjust and how they can help them do so with as little pain as possible.

Some ways to do this include:

*Maintain the Same. Keep to routines as much as possible. While certain toys may have to be given away or a best friend left behind, we can help kids maintain the familiar by keeping to the same evening routines and bedtimes, mealtimes, and other such predictable, daily activities.

*Talk About It. Describe what your child can expect and have him participate in contributing ideas, such as how he might want his new room decorated. Talk about what is good about moving, what might be sad or scary, what will be different, including some of the concrete things to which he can look forward. In the frenzy of a move, talking to your child about his feelings about it might easily be one of the most crucial things you forget to do. So don't let that happen!

*Keep It Together. Make a book together that includes photos of people and places being left behind. This can be a project where you and your child can go visit with and say goodbye to important people and take their pictures (or get handprints, etc.)which can be included in the book. When you are in your new home, this will be a valuable keepsake that you and your child and look at again and again, especially when he or she is especially missing someone.

*Start Fresh. Create new routines and family rituals. Any new city or town you are going to will have different things to offer, which can be incorporated into the family as a regular activity. For instance, if there is a farmer's market in your new town that has a kids musician performing every Saturday morning and your child loves music, going there to enjoy that could become something you could go do together each week.

*Keep Things of Their Own. Separate out some of your child's things - things that he or she wants - into a box, basket, or backpack to keep close by during the actual journey for easy access.

Gather Together. Don't forget to have a goodbye party or even several get togethers so your child has adequate time to say farewell to people he or she cares about - teachers, caregivers, aunts, uncles, grandparents, friends.

By helping your child in these ways, you and your family can enjoy a smoother transition to a new location and home. Even more importantly, you will be helping your child to learn that they can survive and thrive even when their environment and the people in it, are completely different.

Sunday, October 4, 2009

In addition to sharing about what I do in my work with young children and families, which focuses primarily on social and emotional development, I asked them about ways they help to make sure the infants and toddlers who come to them are on a healthy developmental path.

One of their answers? Three little letters: ASQ.

ASQ, or the Ages and Stages Questionnaire, is something I use regularly as well. It is an excellent developmental screening tool broken down by age, from 1 to 66-months.

By asking parents a number of questions (which only takes 10-15 minutes to answer), the ASQ allows us to see how a child is doing within a number of areas: communication, gross motor, fine motor, problem solving, and personal-social.

Why is it so crucial to do regular developmental screenings for your child?

High-quality tools such as the ASQ enable us to catch and address problems or delays early. The sooner your child gets further evaluation and any needed extra support and services, the sooner he or she can get back to where he should be.

Remember, every child is different and normal development happens within a range.

To ensure that your young child reaches his or her potential now and moving forward toward learning his ABCs, developmental screenings are essential.